Academic OB/GYN

A while back I published a bit about how to get insurance appeals approved.   So here’s a specific example.  This regards a young woman who delivered her first infant and was having trouble breastfeeding.  After discharge, her physician recommended home lactation consultation services, which her insurer denied as not medically necessary.  The patient’s policy did cover “skilled” medically necessary home health service , but not “custodial” care, defined as care meant for ongoing maintenance or assistance with daily living.

So here’s an answer to that (nonsense).

Read more…